Healthcare Provider Details

I. General information

NPI: 1649199159
Provider Name (Legal Business Name): CRG CLINICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E KALISTE SALOOM RD STE 3200
LAFAYETTE LA
70508-8507
US

IV. Provider business mailing address

400 E KALISTE SALOOM RD STE 3200
LAFAYETTE LA
70508-8507
US

V. Phone/Fax

Practice location:
  • Phone: 337-277-9055
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: REBEKAH D DAUGEREAUX
Title or Position: OWNER
Credential: LPC
Phone: 337-277-9055